This is what has always troubled me about total lockdown

[Makeitgoaway]

I don't understand how we get out of it.

Of course, it should reduce transmission while we're all locked down but unless the whole world has it under control, as soon as we start getting back to normal, it will all start again. As they're beginning to see in China.

Is this going to become a regular way of life, with lockdown annually or every few years?

Yep, there is a risk for everyone, but much much lower for the young & completely healthy

At some stage, the economy will have to be fully restarted, whatever the death rate

As soon as the antibody test is available, I'm sure the NHS will be testing samples all over the UK,
to estimate the % immunity
and hence the timing of the restart

Grim, but I don't think we can wait anywhere near the 12-18 months for a vaccine, before doing this,
or the predicted Global Depression will become a bottomless pit

So the % immunity will be what we rely on,
plus some of the social distancing habits
plus the retired self-isolating - and being helped re deliveries etc

However, governments won't survive if they don't give their best efforts over the next few weeks to reduce the ensuing death total as much as possible

• and of course, this lockdown gives much needed time to build up NHS capacity / equipment to deal with the new situation

Re whether the lockdown should ever have happened:
in most Western governments, the old are the largest voting group and parties increasingly cater to them.
They would punish any party that blatantly sacrificed them from the beginning as some pp wanted

DCO

1. under-60 previously healthy HCPs are being ventilated at the moment and I understand some have passed already in the UK.

2. tiny, tiny chance x big number = large number in absolute terms of under-60 dead.

3. why do you think we have ITU before COVID? if you and your family are under-60 and healthy, let's hope they don't have a RTA or fall down the stairs and need acute care and ITU when it's full of the people you'd throw under the bus.

4. everything has costs and benefits. You seem confident stopping the lockdown would be economically better irrespective of the number of economically active/spending years lost from the dead.

DCOkeford

I think you are right about a lot of people misunderstanding the purpose of lockdown.

Someone I know actually thought stricter lockdown would shorten the pandemic - when of course it is the complete opposite.

@Zilla1

I mean this gently, but people are going to die.

We can't avoid it.

Personally, if it would make life better for my DC, I would volunteer to be first against the wall, even today.

If I were already in my 70s, it would be a total no-brainer.

Our current approach is being informed my our innate fear of death, which is something we are going to need to reevaluate in the current situation.

DCO,

I mean this kindly but I don't agree with your assumptions. I know everyone dies but decisions made about Covid will affect how much earlier people are going to die than they otherwise would. So as the UK government those to ignore WHO guidance and what South Korea and Singapore and other did (testing and contact tracing) which would have prevented those deaths, the two extremes of choices for the sake of argument are lockdown or not. Bear in mind I don't want either of those but the UK government threw the sensible choice out of the window some time ago.

So if we don't lockdown then I agree most of the deaths will be the elderly (by the way, I don't accept that they're life is worth less as all anyone can lose is their moment but judging by your posts I think you do. I understand that's a view most people hold. Personally I'd have given everything I possess to have stopped my parents passing.) I expect most families probably don't want their elderly relations dying earlier.

I've seen PPs say there's only a 'tiny, tiny' chance of the young dying. But a tiny, tiny chance times by millions of UK population is a large absolute number. How do you think the family of the 31 year old with three children feel now? You mention your DC. Let's hope they aren't one of the tiny, tiny group.

The other group who have been get royally screwed over and would be more so if you stop the lockdown are the HCPs. Do you know how many previously healthy HCPs under-60 are being ventilated atm? How may have died in the UK? So you decide to stop the lockdown then more HCPs die as a result of there being more patients with COVID exposing those HCPs. Many of those HCPs have children. I hope to get through COVID with my DC still having one or both parents alive though the government's decisions about PPE (and previous decisions about testing and contact tracing) make that less likely. It would be nice if HCPs don't have to live with the guilt of bringing COVID home and being responsible for killing our beloved elderly family members because of absent/inadequate/expired PPE but again government decisions about PPE make that more likely than it should be. Perhaps you don't know how bad it is in primary care and in acute though for all I know you might be a GP or a nurse or a ITU consultant.

Again, why do you think we have ITU before COVID. If it's more stretched with COVID patients if we stop lockdown as you want, where will your children or grand children that you'd die for go if they have an RTA or fall down the stairs and need ITU?

Finally, regarding finances, you seem understandably focused on 'putting our children and grand children in debt'. You must have a particularly well developed economic model but I don't think it's clear that the economic costs of lockdown and increased debt to support the economy must be worse than the alternative. I can see Trump thinks that in the USA and others in the UK are saying the same but have you considered the purely financial effects of the millions of deaths of mostly elderly but of the young as well. Simplistically, how many years of pension and spending or economic activity (many over 65s work in the UK) do you think a 65 year old has that would be lost? In big words, have you looked at the counterfactual? What do you think the life expectancy of a 65 year old is? The last time I looked, ONS said it was around 20 years in the UK.

An irony is that the more effective the restrictions are, the longer they must go on for! By slowing transmission the peak number of infected is lowered but it is also pushed later. Keeping that peak down is required to prevent hospital capacity being overwhelmed. Only once the number of infected declines is it reasonable to lift restrictions. By that point a significant proportion of the population are immune and so even a rise in transmission doesn't produce a major peak any more.

I see three ways the current situation ends. One is natural immunity as I describe. Another is if there's an effective vaccine or drug treatment. A vaccine would allow us to accelerate immunity into the population. A treatment could either mean each person is infectious for a shorter time which also slows spread of the virus, or could mean far fewer cases end up in hospitalisation, or both.

But there is a third outcome and it's a chilling one. If Covid-19 mutates in a way that people who caught the original strain can be reinfected, while retaining similar lethality, and if there is no vaccine or easy treatment, then Covid strains could become an endemic disease. In such a scenario the reality is that catching Covid and dying from it becomes a fact of life. It would be like a return to 19th and early 20th centuries when untreatable diseases were rife.

You must have a particularly well developed economic model but I don't think it's clear that the economic costs of lockdown and increased debt to support the economy must be worse than the alternative.

This is the nub of the issue tbh.

What we as a society face is a choice between prolonging the life of people who are inevitably going to die anyway (at the risk of stating the obvious, we all are) and preserving the economy, which will persist indefinitely, long after we (and our DCs) are dead and buried.

Its a difficult one.

Personally, I have had a fabulous life, and would definitely take one for the team.

Other people feel differently.

...and to answer your point about the economic impact of the premature deaths of the over 65s, it is beyond any doubt that this will be a positive for the economy.

The issue of care provision for our elderly population has been brewing for many years now and will be coming home to roost very soon.

Bottom line being that cannot afford to support care for the elderly. Coronavirus, from a purely economic pov is a highly desirable development, as it will kill the elderly before they become an economic burden.

NB, of course there are many other facets to this issue, but from a purely economic perspective, its quite clear cut.

I'll use economic language although as I've said before, I don't think the elderly are of less worth, all anyone can lose is their moment, At any point in time, a child could die in an accident and someone who is 65 can live for 40 more years.

I disagree with you and think it absolutely 'is not beyond doubt' and not 'clear cut'. If you look at it in purely economic terms, the elderly are not an undifferentiated lump, all of whom get alzheimers and consume care, don't have jobs and don't add value to their families through child care that would otherwise need to be purchased. Conversely, many elderly still work through inadequate pensions, many grandparents provide child care and many elderly have economically productive lives. Some 'consume' care and the UK does face a care crisis but to say "from a purely economic pov is a highly desirable development, as it will kill the elderly before they become an economic burden. " is one of the economically least sound statements I've read for quite some time.

Right-o @zilla1

We've all just been imagining the social care crisis then.

I did say 'the UK does face a care crisis' so I'm not sure where you get your last post from. Given that most of the elderly don't require significant social care (and many have jobs, care for grand children and so on), I don't agree the solution to that social care crisis is welcoming or encouraging COVID in a Logan's Run approach. Much like the solution to rape being mostly done by men isn't locking up or castrating all men.

From a quick search so I could be wrong but ONS appear to say c20% of elderly require support with activities of daily living so c80% don't. DWP say c10% of over-65s still have paid employment. C90% of grandparents provide childcare at least once a week. But I expect you're right, the elderly are all the same and, what was it you said, "Coronavirus, from a purely economic pov is a highly desirable development, as it will kill the elderly before they become an economic burden. ".

This is a problem with the FEAR strategy that govt and hysterical MNers are currently promoting. We shouldn't be terrified of cv19 given most of us will get it.

I wish they had gone for a straightforward GUILT scenario instead.
(Cynical DH says it would never work)
But GUILT that you should make sacrifices to save our treasured elderly from premature death would be a better set of messages. You have a social responsibility to others. A more sustainable strategy that will work 12m from now and in all the control conditions, rather than trying to make everyone petrified of it.

Less old people = less pensions to pay and less medical costs (we use up most in our last year or so of life, not so if you aren't allowed into hospital and die quickly of corona)

It really is pretty clearcut economically speaking

I agree that fear is useless as a longer term strategy although everyone seems a bit hysterical at the moment. Fear does enable acceptance of measures people would never normally accept though.

Agreed - almost every communication I have received recently from friends (whatsapp etc) has been signed off 'Stay Safe'

People really do seem to think that the idea behind this lockdown is to 'keep us safe' from catching the virus...

Its really worrying how unquestioning people can be.

Its making me reassess some of my friendships if I'm honest.

It’s more dangerous compliance wise when the adrenaline wears off & boredom sets in.

We’re all going to be working well into our 70s to pay for all this & pensions have lost what, a third (?) of their value already so we certainly won’t be enjoying a golden retirement.

We’re all going to be working well into our 70s to pay for all this & pensions have lost what, a third (?) of their value already so we certainly won’t be enjoying a golden retirement.

Nobody seems to understand this though, its all about #SaveLives

I wonder if/when the penny will drop?

@safariboot I don't think your worst case scenario of mutating endemic fatal coronaviruses is very likely. I know some of the vaccines being researched are designed to prevent ALL coronaviruses. One way or another, we will create a vaccine for this.

We are also losing sight of the fact that if we don't radically change our economy and learn to live with far less consumption, we may go extinct in the next hundred years due to climate change anyway. A temporary hit to this fucked up "economy" we have now may actually be just what we need in the long run.

One thing that hasn't been mentioned on this thread is the theory around viral load.

It seems like if you have a higher viral load (basically more virus in your system), then you're more likely to have a worse outcome (regardless of age). This is one of the reasons (possibly) that HCPs seem to have disproportionately more severe symptoms.

So if you are social distancing, you are more likely to only be infected by a small amount of the virus, and you are likely to have a milder disease, recover and develop immunity. If you are, say working in a school, and get exposed to several asymptomatic children over the course of the day, you'd potentially end up with a higher viral load, and be more likely to have a worse outcome.

If you have a low viral load, you may also be less likely to pass it on to others.

I'm not sure if there's enough evidence for this theory yet for it to be informing government policy, but it is worth bearing in mind.

Also, for those saying this is potentially harmless for the young, the figures from China show a deathrate of 0.2% for 11-18yos. That's about 2 kids per secondary school- that's an unacceptably high risk for a lot of people.

If we have a high number of deaths and lots of people off sick at once across all age groups (which would be the case with no social distancing/lockdown measures in place), then that would damage the economy too.

This is not just about the elderly.

deathrate of 0.2% for 11-18yos. That's about 2 kids per secondary school- that's an unacceptably high risk for a lot of people

That death rate is for people who are actually infected with the virus though, not the general population of that age group.

Unfortunately though, the 'acceptability' or otherwise of a death rate is something that is likely to be out of our hands - we won't get a choice.

Thank you for saying what I wanted to say, but in a nicer way DCOkeford. Covid19 doesn't care what people think is an acceptable death rate. It's a pandemic. Everyone (ok, almost everyone) is catching it sometime soon

I don't have kids and I'm in an at risk group not due to age but another health issue. I should live for another 40+ years but could die if I catch this virus. Personally I would hope that there would be a bed and a ventilator available for me if I need it. The lockdown slows the pandemic down so that those who need medical help will get it which is a good thing. Or should I just be prepared to die for the sake of the economy?

Or should I just be prepared to die for the sake of the economy?

I would be, yes.

Would I expect the next generation to suffer a brutal, decades long recession, never be able to retire, enjoy any of the things that I already have?

Not a chance. It would be incredibly selfish of me to do so.

We are all going to die, the concept of #SaveLives just doesn't exist. A life can never be 'saved', the best we can manage is to postpone the inevitable for a few years.

For me, I would like it if there were drugs/a ventilator available, but if the cost was as exorbitantly high for the next generation as it seems to be in this case, then no, I wouldn't take it.

It's an unconscionable bargain, and I would struggle to live with myself afterwards.